5576 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT
rw IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
" Sanitary Sewage Systems✓w�7 /S Permit Number
,Name Date .s ND 7942
3 Location1i' 'j<✓ 0 _. it /2/i'r�/L✓r
r f = �w� ems. �<° �Y��, .�' •? 'P /r. Afi/ � /yV INS
Subdivision Name Lot No. Sec. or Block No.
Lot Size __ _ House — Mobile Home ____ Business -- Industry
No. Bedrooms c2 _.No, Baths —jQ_— No. in Family.— Public Assembly Other
Garbage Disposal YES ❑ NO [T' Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma -hive YES U NO ❑ ,/�i� ,� ,���
Type Water Supply — �� ----- ---
This permit Void if sewage system described below is not installed within 5 years from date of issue,
This permit is subject to revocation if site plans or the intended use change
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
SYSTEM...;...
I
y
Improvements permit byL
-
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5986.10264
Final Installation Diagram: - System Installed b�
�J
Certificate of Completion__ Date
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
V!/ x d
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
Ir
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
-4 Sanitary. Sewage Systems ,rte ' j/ { Q/� Permit Number
#j` fVame r' t /.� '` Y 9: "i. �_ Date � �._'�� � N2 7942
Location"%} i;, f ii.:. s, ,� j r G,� - r."'.%',�r1 /r - �•sl/r� �",,
Subdivision Name Lot No. Sec. or Block No.
Lot Size _ House — Mobile Home ____ Business __ Industry
No. Bedrooms <=2__. No. Baths _s�-- No. in Family ' _ Public Assembly Other
Garbage Disposal YES ❑ NO E' Specifications for System:
Auto Dish Washer YES 4 NO ❑ .,
Auto Wash Ma^hine YES NO ❑ /� ,� .� ,�%�
r
Type Water Supply _ i��_—
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS w
SYSTEM.
f
Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634.5985. $ f�U
Final Installation Diagram:
System Installed b
Certificate of Completion._ __ Date
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME V%�/el �// G
PHONE NUMBER �VF '17e5 -
ADDRESS ��7-�G� 4�/�� �D� SUBDIVISION NAME
0�LOT #
DIRECTIONS TO SITE YoBI/
5e l' G le" / Tate S r �� c . /* /� fJ.r?�r r•� ��
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY 4�/ SPECIFY PROBLEM OCCURRING
DATE REQUESTED/D /INFORMATION TAKEN BY
This is to certify that the information provided Is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1193
Parcel #: L600000061
Davie County, NC - Basic Estate Search
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Parcel #:L600000061
Account #:52576000
Information
Building:
Tax Codes
BXF•
E5754Owner
ERS BRYAN DALE
Land:
ADVLTAX - COUNTY YT
Market:
NC HIGHWAY 801 SOUTH
ssessed:
FIREADVLTAX - FIRE TAX
Deferred:
OCKSVILLE NC 27028
Property Information
Township
nd (Units/Type): 0.870 AC
JERUSALEM
[Address: 5754 S NC HWY 801
Deed Information
Local tonin
ate: 06/1979 Book: 00108 Page: 0078
Plat Book: Page:
Le al Description
PIN
1.8 AC HWY 801
5766063700
Property Values
Building:
67,0901
BXF•
3,23C
Land:
LME
Market:
86,23C
ssessed:
86,23C
Deferred:
Sales Information
No. Book Pape Month Year Instrument Qual/UnQual Improved Price
1 00108 0078 06 1979 WD Unqualified Improved 0
View Prooerty Record for this Parcel View Map for this Parcel View Tax Bill Information
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Davie County Web Site
All information on this site is prepared for the Inventory of real property found within Davie County. All data Is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned public information sources should be
consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County,
its employees and agents make no warranty as to the correctness or accuracy of the Information set forth on this site whether express or
implied, in fact or in law, Including without limitation the implied warranties of merchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=1463586 8/30/2016